I come back to this again because Merola’s strategy for Burzynski II, as I pointed out, is going to involve “conversion stories” of oncologists who didn’t believe in Burzynski’s magic antineoplastons but do now, attacks on skeptics who have been critical of his work (like me), and, of course, testimonials for success stories. I don’t know how I missed this before, but what exactly that will mean in practice is actually spelled out pretty well in an installment of a video blog by a Burzynski patient named Hannah Bradley. Bradley became famous for her battle against a malignant brain tumor, her decision to go to the Burzynski Clinic, and the prodigious fundraising efforts of her partner Pete Cohen through their Team Hannah website and vlog. In this vlog, recorded on September 7, 2012, Pete and Hannah are happy because in their previous vlog of July 27, 2012, they reported that, after having received Dr. Burzynski’s antineoplaston treatment Hannah has had a “complete response,” and indeed the MRI scans shown in their movie, Hannah’s Anecdote, do appear to show just that (more on that later).

Science-based medicine is great, but it all depends on how you evaluate the scientific evidence. A bad example is the BioInitiative Report (BIR), an egregiously slanted review of health and biological effects of electromagnetic fields (EMF) of the sort that are produced by power lines, cellular telephones, Wi-Fi, and other mainstays of modern life. When first released in 2007, the BIR quickly became a key document used by anti-EMF activists in their various campaigns. Early in January 2013, the BIR appeared in a major update, to extensive media coverage.

The BIR concerns possible biological effects and health hazards of electromagnetic fields in two very different frequency ranges: at extremely low frequencies ELF’s of the sort emitted by power lines and appliances, and at radiofrequencies (RFs) of the sort that are transmitted by mobile phones, Wi-Fi and a host of other technologies. Both ELF and RF fields (which are subsumed under the more general EMF) are part of the electromagnetic spectrum, which includes infrared energy, light, ultraviolet energy, as well as X-rays.

ELF and RF fields are nonionizing, in that the energy of their photons is far too low to break chemical bonds, an effect that makes ionizing radiation such as X-rays so hazardous. Fields from power lines are at 50 or 60 Hz or cycles per second; those from mobile phones and other RF communications and broadcasting systems are in the range of hundreds or thousands of MHz (megahertz or million cycles per second). Simple physics tell us that a photon of 1GHz frequency has an energy of 6 millionths of an electron volt (eV), while the average thermal energy of a molecule is 0.03 eV and the ionization energy of a chemical bond is on the order of 1 eV

There are, of course, well-established hazards from excessive exposures to ELF and RF fields, which are mainly associated with electric shock (ELF) and excessive heating of tissue (RF). Such problems, however, require exposure to fields at vastly higher levels than anything that would be encountered in ordinary life. Most countries around the world have adopted roughly similar exposure limits that are designed to protect against these known hazards.

The possibility that the electromagnetic fields at much lower exposure levels can be bad for you has been a matter of public concern for many years. Countless public, scientific, and legal battles have been waged about possible health hazards produced by fields from power lines, cellular base stations, broadcasting facilities, and other technologies, despite the fact that public exposures from such technologies are invariably far below government exposure limits.(more…)

If you’re a regular reader of this blog, I’ll bet you’re not a regular consumer of vitamins or supplements. I’m in that group. Aside from sporadic vitamin D in winter, I don’t take any vitamins or supplements routinely, nor do I give any to my children. Your reasons may be close to mine: There is little to no evidence suggesting that dietary deficiencies are widespread, nor is there good evidence to suggest that vitamin supplements are beneficial in the absence of deficiency. I don’t have any need for an other supplements, nor am I confident in the scientific evidence for many of them.This position of “no supplements” is a cautious and conservative one, but is based on a consideration of the scientific evidence. I view decisions about healthcare as evaluations of risk and benefit, and then cost if necessary. Given supplementation (with some exceptions) has no demonstrable benefits and, in some cases, a little risk, the odds favour not supplementing in most cases. Add in costs, and it’s even less attractive as a routine health strategy.

Yet a decision not to take vitamins or supplements regularly is becoming a minority position. Supplement use has grown over the past 40 years among Americans, with the National Health and Nutrition Examination Survey (NHANES) showing steadily increasing utilization among younger and older adults:(more…)

Mouse and other animal models are essential to biomedical research. The goal is to find a specific animal model of a human disease and then conduct preliminary research on the animal model in order to determine which research is promising enough to study in humans. There are also non-animal assays and “test tube” type research that is used to screen potential treatments, but scientists still prefer a good animal model.

It is also understood that animal models are imperfect – mice are not humans, after all. Animal research is therefore not a substitute for human research. I and other SBM authors have regularly criticized proponents of dubious treatments who make clinical claims based upon preliminary animal research. Until something is studied in humans, we cannot make any reliable claims about its safety and efficacy in people.

Most reputable sources of nutrition information recommend a diet high in fruits and vegetables and low in red meat. Vegans go much further. Strict vegans reject all animal products including fish, eggs, and milk. Some vegans come across like religious zealots. Here are some comments recently posted by vegans on Facebook:

Right now the biggest social issue facing the world is the violence and suffering of animals.

The dairy industry is the number one feminist issue facing our modern society.

I expect within a generation that milk will be viewed as the most unhealthy habit after cigarettes. I bet it is responsible for more disease than anything else in the US. Dairy products promote all stages of cancer. [In fact, low fat dairy can be protective against some types of cancer]

Milk contains blood and puss[sic]

Humans are not omnivores; they are herbivores. [Most biologists would disagree.]

I was even told that that anyone who really cares about the welfare of others must promote veganism. It seems I am an evil, uncaring person if I waste my time writing about any other subject.

Vegans offer some good arguments based on ethics, environmental protection, cruelty to animals, and sustainability. I won’t get into those issues here. I’ll only address the scientific evidence behind the health claims. How does this description of a video strike you?:

Death in America is largely a foodborne illness. Focusing on studies published just over the last year in peer-reviewed scientific medical journals, [Hardly any of the studies he cites were published over the last year.] Michael Greger, M.D., offers practical advice on how best to feed ourselves and our families to prevent, treat, and even reverse many of the top 15 killers in the United States.[emphasis added] (more…)

I really don’t want to say this, but I feel obligated to. I’m afraid you screwed up. Big time. (Of course, if this weren’t a generally family-friendly blog, where we rarely go beyond PG-13 language, I’d use a term more like one that Penn would use to describe a massive fail, which, as you might guess, also starts with the letter “f”; I think he’d appreciate that.)

I’m referring, of course, to your appearance on The Dr. Oz Show one week ago (video: part 1, part 2, part 3, part 4). Before I begin the criticism, let me just take care of the obligatory but honest statement that I am a fan. I’ve been a fan for a long time. Indeed, I remember seeing you guys perform in Chicago back in the late 1990s when I was doing my fellowship at the University of Chicago. I’ve also seen you in Las Vegas a couple of times, most recently a couple of years ago (see pictures below) at TAM. The two of you have become skeptical icons, through your association with James Randi and over the last several years through your Showtime series Bullshit!, which is advertised with the tagline, “Sacred cows get slaughtered here.” And so they did for the eight seasons Bullshit! was on TV. When you guys were on, it was a thing of beauty to behold, both from the standpoint of entertainment and skepticism.(more…)

My son has been coughing for several weeks, and the cough will probably persist for another 2 or 3 weeks. Coughs last a long time. Patients think a cough will go away in less than a week but in reality they are likely to last several weeks.

Coughs are a pain for the patient and an annoyance for the people around them. You never really know if the cougher in the row behind you has asthma, a post infectious cough or is actively spewing TB or influenza all over the airplane. I learned from Clinton the importance of not inhaling, especially on airplanes.

I tend to leave most symptoms alone if the they are not life threatening or otherwise unbearable for the patient. Codeine is the only really good cough suppressant and none of the over the counter cough medications are effective. I assume that coughing with infection, like diarrhea, is beneficial. Key to treating all infections is to physically remove it. Undrained pus doesn’t heal, and a good cough is the most efficient way I know to remove potential pathogens from the lungs.

If there are benefits to suppressing the cough associated with acute respiratory infections I can’t find any and we have all seen people who, because of inability to cough secondary to rib fractures, develop severe pneumonia. As a resident I had an elderly male die of just such a series of unfortunate events.

I suffer from a mild form the the naturalistic fallacy. I tend to let normal physiologic processes run their course unimpeded as long as they pose no harm to the patient. So I do not treat infectious coughs, in part because medications are not effective, in part there is no benefit and in part because the medications that are effective, and those that are not, have side effects. (more…)

As I hope I demonstrated in Legislative Alchemy: Naturopathy 2013, below, licensing “naturopathic doctors,” especially as primary care physicians, is a bad idea. Unfortunately, the only people usually interested in opposing their licensing efforts are medical doctors and their organizations. Of course, this allows naturopaths to pretend they are the victims of the evil, Big Pharma-controlled medical-industrial complex which kills and maims vast numbers of people every year. This distracts legislators from the real issues, such as whether they are qualified to do what they want to do (answer: no) and whether people really want an ND to provide their care (answer: very, very few).

I happen to think that legislators should be fully informed about things such as how naturopaths are educated, what they do in actual practice, and what thier beliefs about medical care are. So I created a website to inform them about these issues and to inform the public as well, so they too will be inspired to oppose naturopathic licensing. It also has suggestions for opposing naturopathic licensing as well as additional sources of information and downloads of materials you can use. (I thank SBM’s Kimball Atwood, M.D., for permission to use some of the wonderful work he has done on naturopathy.)

The website is titled, most creatively, “Oppose Naturopathic Licensing!” And you can find it here: http://www.no-naturopaths.org/ If those who value science and the rational application of science to medical care don’t work to stop CAM provider licensing, the spread of pseudoscience and quackery will only increase. And that demeans all scientific endeavors.

A fresh season of state legislative sessions is upon us and with it comes the ubiquitous attempts by purveyors of so called “complementary and alternative medicine” (or “CAM”) to join the health care provider fraternity. Via the magic of legislative alchemy, state legislatures transform pseudoscientific diagnoses (e.g., “chronic yeast overgrowth”) and treatments (e.g., homeopathy) into faux, but legal, health care. Once the imprimatur of legitimacy is bestowed by the state in the form of a health care practice act tailored to their special brand of quackery, these newly licensed health care providers are free to foist their practices onto an unsuspecting public and charge them for the privilege. All of this is done under the false assumption that such legislation is necessary to protect the public health, safety and welfare.

We might well want to consider how far this whole thing is going. Will practitioners of CAM split into an ever-expanding number of CAM provider guilds, all with their own practice acts? First, chiropractors were the only CAM practitioners who managed to get themselves licensed in all 50 states. Then along came acupuncturists, who are now licensed to practice in over 40 states. A few states license homeopaths. Some states licensed naturopaths early on. Now the naturopaths, licensed in 16 states, are in a full court press to catch up and legitimize themselves with licenses to practice “naturopathic medicine.”

Snake oil often resides on the apparent cutting edge of medical advance. This is a marketing strategy – exploiting the media hype that often precedes actual scientific advances (even ones that don’t eventually pan out). The slogan of this approach could be, “Turning tomorrow’s possible cures into today’s pseudoscientific snake oil.”

The strategy works because, to the average person, the claims will sound plausible and scientific and will contain familiar scientific buzz words. There is therefore a proliferation of stem cell clinics, anti-oxidant supplements, and personalized genetic medicine.

We can add to the list of cutting edge pseudoscience, neural plasticity and brain training. Neuroscientists are discovering that even the adult brain has greater capacity for plasticity than was previously thought. Plasticity is the capacity of the brain to rewire itself, to acquire new abilities or compensate for damage. Mostly this is simply a technical description of a very common phenomenon – learning. Shoot a basketball 1000 times and (surprising to no one) you (meaning your brain) will get better at shooting baskets. Some of this is physical, such as developing the necessary strength in the involved muscles, but mostly this is the brain learning how to shoot baskets through plasticity.